Dr. Wald joined the faculty at the University of Colorado Denver (UCD) as an Assistant Professor of Medicine in the Divisions of Health Care Policy Research and General Internal Medicine in January 2007. Dr. Wald is Board Certified in Internal Medicine and Geriatric Medicine. In addition Dr. Wald has completed a NRSA Primary Care Research Fellowship and an MSPH degree at UCD. Dr. Wald's work on catheter- associated urinary tract infections (CAUTIs) led to the development of a performance measure endorsed by the National Quality Forum. Dr. Wald's long term career goal is to become an independent investigator focused on patient safety for the hospitalized older adult. Her immediate goals are to 1) develop a framework in which to study evidence-based interventions for CAUTIs;2) obtain additional methodologic expertise with formal coursework;3) participate in related patient safety research for hospitalized older adults;and 4) confine to participate in the care of hospitalized older adults at the University of Colorado Hospital. The patient safety movement has revitalized efforts to reduce the hazards of hospitalization for older adults. This proposal seeks to create a framework to study evidence-based interventions to reduce the hazards of hospitalization using the CAUTI as a prototype. We will first develop a surveillance methodology and use it to measure the effectiveness audit and feedback of catheter duration on medical inpatients at the University of Colorado Hospital. Then, we will test the effectiveness of audit and feedback of catheter duration in multiple hospitals recruited from Nurses Improving the Care of Hospitalized Elders (NICHE). Dr. Wald's research office is in the Division of Health Care Policy Research which houses 45 health services researchers dedicated to studying health care quality in the older population. Dr. Wald's mentor is Andrew Kramer, MD, Professor of Medicine, Chief of the Division of Health Care Policy Research. Co- mentorship will be provided by Dr. Elizabeth Capezuti, Professor of Nursing at New York University, and Dr. Peter Lindenauer, Associate Professor of Medicine at Tufts University. Dr. Wald will work closely with several methodologic consultants. RELEVANCE (See Instructions): The patient safety movement has resulted in unprecedented scrutiny of preventable adverse events in hospitals. One example is Medicare's recent policy of non-payment for "hospital-acquired harms." Also known as hazards of hospitalization, these events were once largely ignored outside of the geriatrics community. The broad goal of this proposal is to create a framework for the study of evidence-based interventions for the hazards of hospitalization for older adults.